As the PReP Impact Trial gives way to Local Authority commissioning of PrEP services, commissioners will be investigating ways of including PrEP in their Tariff Configurations with appropriate tariffs in place to reflect the full cost of drugs and care being delivered.
Implementing this is quite straight forward from our perspective. We discuss with you how best to track the activity. If local codes are needed we issue them and use your description to define when they should be used by the provider. We then work out with you the best way of triggering your new PrEP currencies using these codes and we make the necessary changes to the tariff configuration for your providers. Perhaps an hour's work between us.
The Tariff Rates you charge for each currency is up to the local commissioner to negotiate with their local providers. But they can take a look at some of our published pathways if they need a guide - however, none refer to PrEP at present. We can support commissioners in modelling their own pathways if necessary.
Commissioners will need a Primary and Additional Tariff Rate for each new currency - the Primary is charged if that currency is the most expensive in an episode or visit, the Additional is charged in all other cases - so, if the new PrEP currency is delivered alongside a T5 HIV test, then one or other will be charged at the Additional rate and it thereby exclude any presumed duplicated activity (eg register meet and greet, health promotion, examination etc).
Things to watch out for are:
Don't double pay for the same activity, when you design your new PrEP currency(s) be sure to identify the scope / boundary of the activity included - who pays for the drugs, the delivery care etc. Is it delivered alongside a test or some other activity attracting a tariff, in which case the test would be coded normally and would attract its own tariff (unless we make an adjustment) etc.
We recommend you write down your intention for each new currency in plain english being as specific and comprehensive as possible - we can then discuss it with you and test the boundaries to come up with a way to implement it without corrupting your existing tariff configuration.
When we have some template solutions for PrEP currencies, we will publish them.